Gasparini Angela, Jiang Serena, Mani Riccardo, Tatta Tiziana, Gallo Oreste
Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy.
Department of Pathology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy.
Cancers (Basel). 2024 Oct 15;16(20):3492. doi: 10.3390/cancers16203492.
Ganglioneuroma (GN) is a rare, benign tumor of the autonomic nervous system. It is seldom located in the head and neck (HN) region. GN typically presents as a slow-growing, painless mass, often leading to delayed diagnosis. We report a unique case of laryngeal-originating GN in a 43-year-old female who presented with worsening dysphonia and dyspnea. Imaging revealed a large mass originating from the larynx. Histological examination confirmed the diagnosis. The tumor was surgically excised with preservation of key structures in the neck. At the follow-up, the patient experienced a significant improvement in symptoms. A systematic literature review following PRISMA guidelines was conducted in January 2024 to investigate the common sites of GN in the HN region and the complications associated with its treatment. In a total of 58 articles, we studied 65 patients, mostly under 30 years old. Surgical excision remains the primary treatment, and post-operative complications were mostly neurological. GNs are generally slow-growing and asymptomatic, but they can reveal themselves when compressing nearby structures, especially in the HN region. In symptomatic cases or when the tumor exhibits significant growth or hormonal activity, surgical resection is required. The lateral cervical approach is the most common one. The risk of postoperative complications and recurrence underscores the need for careful surgical planning and long-term follow-up. This unique laryngeal GN case highlights the importance of considering GN in the differential diagnosis of HN masses. Further large-scale studies are warranted to establish evidence-based protocols for their management, especially in the HN region.
神经节细胞瘤(GN)是一种罕见的自主神经系统良性肿瘤。它很少位于头颈部(HN)区域。GN通常表现为生长缓慢、无痛性肿块,常导致诊断延迟。我们报告了一例独特的起源于喉部的GN病例,患者为一名43岁女性,表现为进行性加重的声音嘶哑和呼吸困难。影像学检查显示一个起源于喉部的大肿块。组织学检查确诊了该疾病。肿瘤通过手术切除,同时保留了颈部的关键结构。随访时,患者症状有显著改善。2024年1月,我们按照PRISMA指南进行了一项系统的文献综述,以调查HN区域GN的常见部位及其治疗相关并发症。在总共58篇文章中,我们研究了65例患者,大多数年龄在30岁以下。手术切除仍然是主要治疗方法,术后并发症大多为神经方面的。GN通常生长缓慢且无症状,但当压迫附近结构时会显现出来,尤其是在HN区域。在有症状的病例中,或者当肿瘤出现显著生长或激素活性时,需要进行手术切除。颈外侧入路是最常用的方法。术后并发症和复发的风险凸显了仔细的手术规划和长期随访的必要性。这例独特的喉部GN病例突出了在HN肿块的鉴别诊断中考虑GN的重要性。有必要进行进一步的大规模研究,以建立基于证据的管理方案,尤其是在HN区域。